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Disease Epidemiology/Clinical Course

Session: Poster Session A

(188) Risk factor of death after the first suicidal behavior in patients with depressive disorder

Friday, August 25, 2023

8:00 AM – 6:00 PM ADT

Location: Convention Hall

Publication Number: 523

Presenting Author(s)

Michael Chun-Yuan Cheng, MA (he/him/his)

Research Associate
School of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Taiwan, Taiwan (Republic of China)

Background: Suicidal behavior is a crucial outcome in caring for patients with depressive disorder. Death or survival after suicidal behavior was associated with the strength of the intention to suicide. Figuring out why some people with specific characteristics died after suicidal behavior rather than survived not only can improve the care system for patients with depression, but also can save more lives.

Objectives: To evaluate the potential risk factors associated with mortality in patients with depression after the first suicidal behavior.

Methods: We implemented a nested case-control study by analyzing Taiwan’s National Health Insurance Database. The study cohort included patients newly diagnosed with depression during 2011-2020, and the definitions of cases and controls were defined as the deaths or survivals in patients after the first suicidal behavior. Every case would be matched to 5 controls based on the time intervals between the first depression diagnosis date and the date of the first suicidal behavior. The potential risk factors, including comorbidities, drug use, living residency, and other patients’ important characteristics during one year before the first suicidal behavior were collected. We use stepwise logistic regression to estimate the relationship between these factors and death after the first suicidal behavior.

Results: We included a total of 5,668 cases and 17,998 controls during the study period. We found the male (OR 2.23, 95% 2.08-2.40) and patients with schizophrenia (OR 3.07, 95%2.75-3.44), sleep disorders (OR 1.35, 95% 1.24-1.46) or cataract (OR: 1.66, 95% 1.42-1.87), the uses of hypnotics (OR 1.49, 95% 1.36-1.64), bupropion (OR 1.33, 95% 1.18-1.10), agomelatine (OR 2.01, 95% 1.72-2.35), mirtazapine (OR 1.56, 95% 1.42-1.70) were associated with the increased risks of death.

Conclusions: More attention should be paid to the males, patients comorbid with some specific psychiatric diseases, or receiving specific anti-depressants in patients with depression after the first suicidal behavior to avoid the excess mortality risk in this vulnerable population.